One health issue that’s rarely talked about, despite its prevalence, is erectile dysfunction (ED). In the U.S., the condition affects over 30 million men – most of whom are older adults. While ED is commonly seen in older men, it’s important to note that it’s not due to the normal aging process.

Erectile dysfunction is a condition in which a man has trouble getting or keeping an erection, especially during sexual intercourse. In the past, ED was believed to be a psychological problem; researchers have now identified it to be an indicator of any number of chronic diseases that restrict blood flow to the penis. Diseases like diabetes, hypertension, and kidney failure, and stress disorders like depression and anxiety are just some conditions that cause ED in men.

For a condition that’s not discussed often, the drug used to treat it is relatively well-known. Sildenafil citrate – better known by its brand name Viagra – is often prescribed to treat ED, as well as pulmonary hypertension. However, it isn’t without its side effects, which include prolonged, painful erections, sudden vision loss, seizures, and symptoms similar to a heart attack.

Another study published in the Asian Journal of Andrology also looked at the association between folic acid deficiency and male sexual problems like ED and premature ejaculation. The latter is a condition where a man ejaculates within a minute after penetration. Researchers from Renmin Hospital of Wuhan University in China assessed folic acid levels in over 100 men suffering from ED, premature ejaculation, or both. Their results revealed that those who had either condition suffered from lower folic acid levels compared to men without the conditions. In a separate study using a leporine model for diabetes, researchers found that treating the rabbits with folic acid greatly improved their quality of erections, indicating that folic acid could have the potential to improve erections.

Aside from improving sexual function, folic acid also plays a role in male fertility. Research shows that combining folic acid and zinc can potentially improve total sperm count in both fertile and subfertile men by as much as 74 percent. However, men with abnormally low sperm counts might not benefit as much, as the combination did not significantly boost sperm health in this group of men. (Related: Depression in men linked to folic acid deficiency.)